<h2>Evaluation form</h2>
<p>Inorder to evaluate the effectivness of using this method of providing captchas </p>
<!--Small text -->
<h5>* fields must be complete</h5>
  <form method='post' action='formresults.php'>
  <table cellpadding="7">
   <tr>
     <td>1) Email Address*:</td>
     <td><input type='text' id='email'  name='email' size="45" /></td>
   </tr>
   <tr>
   <!--Begining of table cell-->
   <td>2) What is the status of your vision?*:</td>
   <td>
   <table>
   <tr>
      <td>Sighted:</td>
      <td><input type="radio"  name="vision" value="sighted" /></td>
      <td>Partially Sighted:</td>
      <td><input type="radio"  name="vision" value="partial" /></td>
      <td>Blind:</td>
      <td> <input type="radio"   name="vision" value="blind" /></td>
   </tr>
   </table>
   </td>
   </tr>
   <!--End of table cell-->
   <tr>
      <td>3) If relevant which screen reader do you use?: </td>
      <td><input type="text" id="reader" name="reader" size="45" /></td>
   </tr>
   <tr>
   <td>4) How easy to use was the system?*:</td>
   <td align="center">
   <table>

   <tr>
     <td align="center">Easy</td>
     <td align="center"><input type="radio"  name="satisfaction" value="1" /></td>
     <td align="center"><input type="radio"  name="satisfaction" value="2" /></td>
     <td align="center"><input type="radio"  name="satisfaction" value="3" /></td>
     <td align="center"><input type="radio"  name="satisfaction" value="4" /></td>
     <td align="center"><input type="radio"  name="satisfaction" value="5" /></td>
    <td align="center">Difficult</td>
   </tr>
   </table>
   </td>
   </tr>



  <tr>
   <td>4) How well did the system perform?: </td>
   <td align="center">
   <table>
   <tr>
    <td align="center">Extremely Well</td>
     <td align="center"><input type="radio"  name="mental" value="1" /></td>
     <td align="center"><input type="radio"  name="mental" value="2" /></td>
     <td align="center"><input type="radio"  name="mental" value="3" /></td>
     <td align="center"><input type="radio"  name="mental" value="4" /></td>
     <td align="center"><input type="radio"  name="mental" value="5" /></td>
    <td align="center">Very Poorly</td>
   </tr>
   </table>
   </td>
  </tr>
 

  <tr>
   <td>4) How mentally demanding was the system to use?: </td>
   <td align="center">
   <table>
   <tr>
    <td align="center">Easy</td>
     <td align="center"><input type="radio"  name="mental" value="1" /></td>
     <td align="center"><input type="radio"  name="mental" value="2" /></td>
     <td align="center"><input type="radio"  name="mental" value="3" /></td>
     <td align="center"><input type="radio"  name="mental" value="4" /></td>
     <td align="center"><input type="radio"  name="mental" value="5" /></td>
    <td align="center">Challenging</td>
   </tr>
   </table>
   </td>
  </tr>

  <tr>
   <td>4) How Frustrating was it to use the system?: </td>

   <td align="center">
   <table>
   <tr>
    <td align="center">Satisfying</td>
     <td align="center"><input type="radio"  name="frustration" value="1" /></td>
     <td align="center"><input type="radio"  name="frustration" value="2" /></td>
     <td align="center"><input type="radio"  name="frustration" value="3" /></td>
     <td align="center"><input type="radio"  name="frustration" value="4" /></td>
     <td align="center"><input type="radio"  name="frustration" value="5" /></td>
    <td align="center">Frustrating</td>
   </tr>
   </table>
   </td>
   </tr>


   <tr>
   <!-- Get the age range of the person -->
   <td>5) What age are you?</td>
   <td>
    <select id='age'>
     <!--Probably didn't look at it-->
     <option value='1-10'>1-10</option>
     <option value='11-20'>11-20</option>
     <option value='21-30'>21-30</option>
     <option value='31-40'>31-40 </option>
     <option value='41-50'>41-50 </option
     <option value='51-60'>51-60 </option>
     <option value='61-70'>61-70 </option>
     <option value='71-80'>71-80 </option>
     <option value='81-90'>81-90 </option>
     <option value='91-*'>91-*</option>
    </select>
   </td>
   </tr>
 
   <tr>
     <td valign="top">5) Other Comments:</td>
     <td>
        <textarea tabindex="5" cols="45" rows="15" id="comments"> 
        </textarea>
     </td>
   </tr>
   <tr>
     <td colspan='2' align='right'>
          <input type='submit' value='Submit' />
     </td>
  </tr>

 </table>
</form>


